腰椎间孔镜治疗腰椎间盘突出并神经根管狭窄临床观察

目的探讨腰椎间孔镜治疗腰椎间盘突出症并神经根管狭窄患者临床疗效。方法自2015年1月至2016年6月收治40例腰椎间盘突出症并神经根管狭窄患者，按照随机数字表均分为两组。观察组使用微创椎间孔镜下椎间盘髓核摘除术，对照组采取经椎间孔入路椎体间融合术（TLIF）。比较两组患者炎性因子、疼痛介质、视觉模拟评分法（VAS）评估腰腿疼痛、术中出血量、术后下地时间、手术并发症发生等情况、JOA总评分、Oswestry功能障碍指数问卷表（ODI）和MacNab等评估疗效。结果观察组在炎性因子、疼痛介质、腰腿疼痛缓解、术后下地时间、术中出血量、手术并发症发生、JOA总评分、ODI和Mac Nab评估疗效改善等方面优于对照组，差异有统计学意义（P〈0．05）。结论椎间孔镜治疗腰椎间盘突出症并神经根管狭窄患者与TLIF术比较，具有创伤小、恢复快等优点，可以取得较好疗效。

Objective To evaluate the clinical efficacy of minimal invasive transforaminal endoscopic spine system for treatment of lumbar intervertebral disc herniation with steno-sis of spinal nerve root canal. Methods From January 2015 to June 2014, forty lumbar intervertebral disc herniation with steno-sis of spinal nerve root canal patients were randomly divided into two groups according to the random number table.The research group had undergone percutaneous transforaminal endoscopic discectomy .The control group were treated by transforaminal lumbar interbody fusion （ TLIF ） .The inflammatory factor, pain medium, visual analogue scale （ VAS ） , the intraoperative blood loss, postoperative down time, the surgical complications, the Japanese Orthopaedic Association Scores （ JOA ） , ODI score and Mac Nab＇s criteria in the two groups were reviewed and compared between the preoperative and postoperative. Results The research group had ascendant than the control group in the Mac Nab＇s criteria, ODI score, VAS score, JOA score, the intraoperative blood loss, the surgical complications.There differences were significant （P〈0.05） . Conclusion The minimal invasive transforaminal endoscopic spine system for treatment of lumbar intervertebral disc herniation with steno-sis of spinal nerve root canal patients has the advantages of small trauma, earlier rehabilitation, and good effect.